Peter Randall Shumaker, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

A99780 Issued in CA

Practice address

Naval Medical Ctr
34800 Bob Wilson Dr., Ste 300
San Diego, CA 92134-0001

Phone

(619) 532-9660

NPI assigned

Jan 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bernardo Dermatology Medical Group Inc

  • Dermatology Physician
  • Poway, CA
  • NPI 1407950785
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1982682852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CTR",
            "address_2": "34800 BOB WILSON DR., STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CTR",
            "address_2": "34800 BOB WILSON DR., STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMAKER",
        "first_name": "PETER",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A99780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Nicole Shull, RN
• Danielle Shulman, OT
• Mark A Shulman, DPT
• Adam Michael Shults, PA-C
• Karen L. Shultz, RN
• Suzanne Shumaker
• Shumard Chiropractic Inc
• Jason Alan Shumard, D.C.
• Katherine Shumilo
• Stephen Shumpert, MD

• Procedural Dermatology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.